Just switched from S9 VPAP to Air Sense 10 Autoset for her

[peke]

I have not downloaded OSCAR yet, but I will do that today.

I started on Cpap in 1998, then went to Bipap, then in 2007, I started using Res-Med's Adapt SV when I started having way too many Central Apneas. I think the high pressure setting were causing the Centrals, but I am not an expert. When the Adapt SV started having problems, I began using the S9 Vpap. It was about 6-7 years old, so I wanted to get a new machine. Tricare will only pay for Cpaps, not bipaps or vpaps, so that is what I got.

I needed to do some tweaking so this what I have done so far...

1. I went into the clinician's menu and changed the Essential PLUS.
2. I changed the START pressure from 4.0 to 5.0, because I wasn't getting enough air when it first turned on. I kept having to take air in through my mouth a couple of times because it felt like I was suffocating.

Current settings:
Mode-auto set for her
Max pressure 15
Min pressure 5
Start pressure 5
EPR on. Level 1 Full time
Smart Start off because of the minimum 7 needed
Essentials PLUS
Tube temp 75° F

Sleep report: last night
Usage hours- 7 hrs 30 min
Events per hour- 1.7

Under More Info:
Days used 19/19
Pressure- 11.9
Leak- 24L/min
AHI-1.9
Total AI- 1.3
Central AI- 0.5

My questions:
1. Was it a good idea to change Start pressure to 5?

2. On the machine's sleep report, on the Events per Hour, is that an average for the 7 hrs 30 min?

3. Under More Info, it says pressure was 11.9. Does that mean an average for the total 19 days or just for last nigh? Or average per hour?

4. Same question for Leak, AHI, Total AI, and Central AI. Does it mean an average for the 19 days or just last night?

5. Difference between AHI and Total AI? AHI has hypopneas included and AI does not?

6. My centrals were low. When I had higher pressure on the cpap and BIPAP, I used to wake up gasping for air and my centrals were high. Oxygen was at 80% then, too. I don't have any of the old data, but I think the doctors (4 different doctors) had set it from 14-25. Does this mean the high pressure was causing my centrals?

7. Do the numbers look good so far since I stopped using the VPAP?

8. After I download OSCAR, should I post any of the reports?

9. The DME did not install an SD card. The clinician's manual said the autoset comes with one, but the DME told me that it did not. She is mailing me a Respironics card because that is the brand they usually sell. Will the Respironics sd card work in the Res-Med?

10. Cellular service- I only have 1 bar and sometimes 0 bars. Is that enough bars to send data? When I visit another country, should I turn airplane mode on? DME said to turn airplane mode on so I would not pay for expensive cell service. Then she said to turn airplane mode off when I get back to the U.S. She said all of the days would then send reports. This makes no sense to me because I am not paying for cell service on the machine, am I? I understand that I need to use airplane mode during the flight, but why keep it on while in another country?

Thank you for any advice!

[chunkyfrog]

. . . Tricare will only pay for Cpaps, not bipaps or vpaps . . .

What a lovely way to thank you for your service!

[peke]

Well, my husband's service, but I get the point! I did not understand how an insurance company can not give you what doctors prescribe. That is like saying..."We won't pay for a heart operation, but you can have a hernia operation instead."

[chunkyfrog]

Did Tricare say this, or was it a DME?
Never take the word of a supplier--they tend to prevaricate--a lot.
If someone other than Tricare told you that, they might be in deep doo-doo.

[Dog Slobber]

1. Was it a good idea to change Start pressure to 5?

It was a good idea to increase your Start/Min pressure, because you were experiencing discomfort at 4. We don't know that 5 is optimum and given the importance of minimum, it *might* be too low. We need OSCAR traces to know better.

2. On the machine's sleep report, on the Events per Hour, is that an average for the 7 hrs 30 min?

Yes

3. Under More Info, it says pressure was 11.9. Does that mean an average for the total 19 days or just for last nigh? Or average per hour?

It is the average pressure over the selected period. You can select the reporting period: 1 Day / 1 Week / 1 Month / 3 Months / 6 Months / 1 Year

4. Same question for Leak, AHI, Total AI, and Central AI. Does it mean an average for the 19 days or just last night?

All of the reported information in the More info is for the selected period.

5. Difference between AHI and Total AI? AHI has hypopneas included and AI does not?

I *believe* so, judging by the lack of H in the filed name, but the manual doesn't specifically say.

6. My centrals were low. When I had higher pressure on the cpap and BIPAP, I used to wake up gasping for air and my centrals were high. Oxygen was at 80% then, too. I don't have any of the old data, but I think the doctors (4 different doctors) had set it from 14-25. Does this mean the high pressure was causing my centrals?

Possibly, but without actually numbers and graphs, there is a lot of speculation.

7. Do the numbers look good so far since I stopped using the VPAP?

Your leaks are high, but otherwise, pretty good, I'm guessing they could be improved. More importantly how do you feel?

8. After I download OSCAR, should I post any of the reports?

Yes

9. The DME did not install an SD card. The clinician's manual said the autoset comes with one, but the DME told me that it did not. She is mailing me a Respironics card because that is the brand they usually sell. Will the Respironics sd card work in the Res-Med?

Any SD Card (less than 32 GB) will work. More people are reporting their machines not coming with SD Cards.

10. Cellular service- I only have 1 bar and sometimes 0 bars. Is that enough bars to send data? When I visit another country, should I turn airplane mode on? DME said to turn airplane mode on so I would not pay for expensive cell service. Then she said to turn airplane mode off when I get back to the U.S. She said all of the days would then send reports. This makes no sense to me because I am not paying for cell service on the machine, am I? I understand that I need to use airplane mode during the flight, but why keep it on while in another country?

1 bar should be fine, and no you don't need to turn on Airplane Mode when travelling. What she meant about getting back to the US, is when the device can't send data (for whatever reason), it will catch up and send all non-sent data when it does have service.

Your DME is wrong about being billed. There is no mechanism in place for ResMed, Cell providers, DMEs to bill cell charges back to the end-user.

The fact that your DME just made this up, is pretty good evidence that everything they tell you should be questioned.

[Okie bipap]

As others have said, check with your local TRICARE office. If your doctor prescribed a bi-level or ASV machine, it should be covered under the TRICARE durable medical equipment coverage. If your current machine was not purchased through the TRICARE insurance, you may have to go through the routine of trying CPAP, then if that doesn't prove effective, move up to a bi-level machine, then if that doesn't prove effective, finally move up to an ASV machine. They typically don't want to spend that much money without proving you have a valid need for the ASV machine. TRICARE was not around when I was active military, and I currently use Medicare and TRICARE for life. My wife and I both use bi-level machines that were purchased through Medicare and TRICARE for life.